NPI 1184170508

B&g Management Services LLC

Organisation Preferred Provider Organization American Fork, UT

Practice location

Address: 186 S 1100 E, American Fork, UT 84003-2817
Phone: (801) 756-5136

Authorised official

Name: Michael Brandon Green
Title: Dr. M. Brandon Green DDS/ Owner
Phone: (801) 756-5136

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 6229925 (UT)

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Registry record

NPI: 1184170508
Entity type: Organization
NPI issued: 26 Aug 2016
Record last updated: 26 Aug 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.